Provider Demographics
NPI:1114355641
Name:ERWIN, TERRY CHRIS (FNP)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:CHRIS
Last Name:ERWIN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:ERWIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:109 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-4940
Mailing Address - Country:US
Mailing Address - Phone:940-654-6200
Mailing Address - Fax:940-325-2202
Practice Address - Street 1:109 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-4940
Practice Address - Country:US
Practice Address - Phone:940-654-6200
Practice Address - Fax:940-325-2202
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily